The protest organized by Regina Holliday over a patient’s right to access their medical information is not quite the same magnitude as agitating for integration in 1950s-era Alabama. Yet there are intriguing similarities between the crusade Rosa Parks launched then and what Holliday is attempting today. Both involve a refusal to accept second-class status and a resolve to push back against entrenched institutions.
While it’s comforting to just blame the GOP for the unhappiness with health reform threatening the president’s re-election, the truth is that Barack Obama repeatedly botched, bungled and bobbled the health reform message. There were three big mistakes:
The Passionless Play While Candidate Obama proclaimed a passionate moral commitment to fix American health care, President Obama delved into legislative details.
The Medicare program is betting on a new course of action to curb what one medical journal has dubbed an “epidemic” of uncontrolled patient harm.
The effort is pegged to the success of a little-known entity called a “hospital engagement network” (HEN). In December, the government selected 26 HENs and charged them with preventingmore than 60,000 deaths and 1.8 million injuries from so-called “hospital-acquired conditions” over the next three years. That would be the equivalent of eliminating all deaths from HIV/AIDS or homicide over the same period.
You can’t get much cooler than HealthTap: slick Silicon Valley start-up, social media darling, savvy and successful backers. But when you closely examine the service HealthTap actually provides, the money and good looks fall away. Like in the fable about “the emperor’s new clothes,” behind the buzz, there’s nothing there.
OK, maybe one thing: a really risky way to get medical advice.
[U]sers post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in gamelike competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site.
Fellow physicians can show that they concur with the advice offered by clicking “Agree,” and users can show their appreciation with a “Thank” button.
Is the New York Giants bathroom more sanitary than your hospital room? Could be. And that player cleanliness may even have helped send the team to the Super Bowl.
Freakonomics co-author and self-confessed germophobe Stephen Dubner, working on a Football Freakonomics segment for the National Football League, noticed that every urinal in the football Giants’ bathroom had a plastic pump bottle of hand sanitizer perched on top – a phenomenon he promptly documented photographically.
OK, maybe I misread the cover of the dog-eared copy of Glamour perched in a magazine rack at the gym. Perhaps I was confused by the multi-colored headlines promising an improved physical appearance (“101 One Minute Makeover Tricks”), a more organized daily routine (“12 Ways to Get Your Sh*T Together”) and, of course, better sex (“Guys Talk Sex! The 16 Things Almost EveryMan is Attracted To”).
(Note to other males: No, I couldn’t get up to sixteen, either.)
While Texas Governor Rick Perry rails against the evils of federal involvement in health care on the GOP presidential campaign trail, businesses back home are busy raking in record profits from government dollars.
“By largely exiting the employer market and focusing on Medicare and Medicaid, Texas HMOs have enjoyed strong and growing profits in the last six years,” concluded the newly issued Texas Health Market Review 2011, an analysis of financial filings by state plans. It added, “HMOs here now are focused on the niche businesses of Medicare and Medicaid, both of which were strongly profitable in 2010. Overall, Texas HMOs reported net income of $404.1 million in 2010, or 3.3% of underwriting revenues of $12.41 billion.”
Like everyone else, I’ve cheerfully hummed, whistled and sung along to Rudolph the Red-Nosed Reindeer for as long as I can remember. But when I listened carefully to the lyrics this holiday season, I realized I’d missed the underlying message of a song that teaches invaluable lessons about the challenge of running a successful company.
Like a true advocate, you write here in what I call “present tense hopeful.” In actual English, “has arrived” means something is here. And so it is for a very few cancers in a very few ways, none of which are generally curative. (See current Medscape article that came out this week.)
My wife was lying in the back of an ambulance, dazed and bloody, while I sat in the front, distraught and distracted. We had been bicycling in a quiet neighborhood in southern Maine when she hit the handbrakes too hard and catapulted over the handlebars, turning our first day of vacation into a race to the nearest hospital.
Pat Mastors, a patient safety advocate, has written aclever blog post called, “A Few More Minutes with Andy Rooney.” Channeling the curmudgeonly tones of a 60 Minutes commentary, it begins:
I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.
But then I read what killed me: “serious complications following minor surgery.”
Now what the heck is that?
The blog goes on to have Rooney ask for someone to find out what actually killed him. This has offended some respondents who, blinded by their own biases, think a writer using a celebrity’s death to push for information that could be used to improve care is the same thing as accusing his physicians of negligence or hauling Rooney’s family into court to publicly disclose private details.
The way that Michael Long and Sandeep Green Vaswami want to change hospital care may well rank as both the most commonsensical and most hopeless health reform proposal ever. The real question is whether they can show the same tenacity in pursuing their goal as an elderly Jewish woman from Munster, Ind., who has invested nearly two decades in a similar effort.
What the two men are advocating is simple: hospitals should offer the same level of professional staffing and patient care on weekends as during the rest of the week. They should do this, the two men write in the Health Affairs blog, because trying to cram seven days of care into five leads to a cascade of problems that harm and even kill patients. It also costs a lot of money.
When former House Speaker Newt Gingrich announced his bid for the GOP presidential nomination, I found myself singing a few bars from Night Moves, Bob Seger’s hard-driving tribute to teenage hormones: “I used her, she used me/But neither one cared./We were gettin’ our share.
“No, this isn’t one more commentary on the Georgia Republican’s checkered marital past. I’m referring to a different relationship, the one between Gingrich and the health policy community. A critical component of the climb back to prominence for a man who inspired nearly as much distrust in his own party as in the opposition was proving he could work harmoniously with those holding differing views on an important policy issue — how to reform U.S. health care.
In the near-decade since the Sept. 11, 2001, terror attacks, the “War on Terror” has cost the United States about $1.3 trillion, according to the National Center on Defense Information.
By comparison, it took just six months for the U.S. to spend that much money on health care, based on the $2.5 trillion spent in 2009.
Why does that comparison matter? Because as health care costs rise, they have begun to crowd out the money available in state and federal budgets for elementary and secondary education, infrastructure and other pressing human needs. The War on Terror isn’t going away and, in fact, may increase in intensity in the short term if fears of Al Qaeda retaliation prove true, so we won’t be de-funding the military to provide to get money to shore up crumbling bridges, roads and schools.
A 2009 report from the Office of Management and Budget put it plainly: “The Federal Government’s long-term fiscal shortfall is driven primarily by escalating health care costs…These growth rates are simply unsustainable and are why slowing the growth in health care costs is the single most important step we can take to put the Nation on firm fiscal footing.”
David Walker, the former U.S. Comptroller General turned crusader for fiscal responsibility, has said repeatedly, “If there’s one thing that could bankrupt American, it’s health care costs.”
Perhaps some of the patriotic unity inspired by the successful operation to kill Osama bin Laden can carry over to the efforts to responsibility control health care costs and preserve what makes America great. Not very likely – but, hey, one can always dream.
Michael Millenson, a health care consultant who many moons ago worked as I did at the Chicago Tribune, has offered a scathing critique of the Center for Medicare and Medicaid Services’ proposed rules for setting up accountable care organizations (ACOs), which are health care reform’s primary delivery system reform. Says Millenson on theHealth Care Blog: